U.K. Hopes to Conquer Death’s Taboo

The “taboo” surrounding death discourages people from writing up wills or thinking about funeral arrangements, some British ministers believe. The solution, some say, is “open days” at funeral homes and crematoria, writes the Guardian.

Dominic Maguire of the National Association of Funeral Directors applauds the idea, telling the Guardian, “People make provision for things that might never happen such as getting car insurance. But so few people make provision for the inevitable – death.”

The program will also fund at-home deaths with “round-the-clock support” after evidence that home is where most people would prefer to die.

End-of-life planning is seen as a “neglected area” of the U.K.’s National Health Service. Paul Cann of the group Help the Aged told the BBC, “For far too long, there has been a presumption that death should be at the convenience of the system, as opposed to respecting the individual wishes of those who are approaching their final days.”

The government program will cost £286 million ($573 million) over three years and “intends to allow more people coming to the end of their lives to die at home by giving them round-the-clock support.” According to the Guardian, “Less than one in five people (18%) die at home, but two-thirds say it is where they would prefer to end their life.”

Health Secretary Alan Johnson said earlier in July that “changing the way the system works” is as important as simply funding the initiative. He added that he “wanted to start a national debate to get people talking about death.” Campaigners for better end-of-life care are just hoping that the British parliament’s plan can “turn fine words into action.”

Esther Rantzen, a longtime British TV talk show host, conducted a survey for a BBC program in 2005, finding that there “needed to be a change in attitude in the medical profession and among people in general…we and the rest of the population need to make our wishes clear and...the medical profession needs to up this in priority.”

Doctor training will be part of the NHS’s new program, helping to improve dialogues between older patients and their doctors. Professor Mike Richards of the National Clinic for Cancer told the health publication Pulse Today that “there is a need to provide education and training” to doctors “for the communication skills needed” to initiate conversations about end of life issues. “[A]s doctors we are not trained in this area.”

A 2003 article in the International Journal of Integrated Care outlined the status of end of life care in the United States, suggesting that the programs, chiefly provided by Medicare and Medicaid, are “fragmented and uncoordinated.” But the authors used four end-of-life care organizations around the country as leading examples of how the system can be improved. These include non-profit hospices and those that contract with Medicare and Medicaid.